34D2060429 CLIA NUMBER - WALGREENS #9562

Laboratory Demographics

  • CLIA Code: 34D2060429
  • Facility Name: WALGREENS #9562
  • Facility Address: 820 N DEKALB ST
    SHELBY, NC
    ZIP 28150
  • Facility Phone: 704 481-1784
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRANDON MATHEON
  • NPI Number: 1659386753
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2060429
LAB Type Pharmacy
Facility Name WALGREENS #9562
Street 820 N DEKALB ST
City SHELBY
State NC
ZIP 28150
Phone 704 481-1784
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/12/2025
Certificate Expiration Date 4/11/2027
Facility Type Pharmacy
Lab Director BRANDON MATHEON

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This page was last updated on: 9/29/2025